Back In MotionEltham

What is it?

Have you ever been able to do the splits or been referred to as being “double jointed” or very flexible?

Joint hypermobility means that you have more movement and laxity in individual joints than normal³. This is not necessarily a bad thing and some people do not have any symptoms, we see a lot of hypermobility in dancers and gymnasts and it is very common, particularly in children and females⁴.

Unfortunately, sometimes having increased movement in joints can increase the risk of other injuries. It is only when individuals experience pain without any known conditions or injuries for three months and have hypermobility in multiple joints that they may be diagnosed with hypermobility syndrome⁵.

Other symptoms of hypermobility syndrome may include but are not limited to⁶:

• Headaches;
• increased fatigue and tiredness;
• nervousness and anxiety;
• joint subluxations and dislocations and sprains;
• dizziness and balance disturbances;
• gastrointestinal problems;
• muscle pains; and
• persistent joint pain

How is hypermobility diagnosed?

Your health practitioner such as your physiotherapist or osteopath can help diagnose hypermobility. The physiotherapist or osteopath will ask you a series of questions to gain your medical history and understand more about your condition. If hypermobility is suspected, your clinician may use an assessment tool to look at the movement in your lower back, knees, elbows, thumb and little finger to determine if you have more movement than the average ranges¹.

In some cases, you may be referred to your doctor to perform more assessments to rule out other health conditions.

How can physiotherapy or osteopathy assist?

It is important to have a formal assessment performed by a physiotherapist or osteopath to determine if you have hypermobile joints or hypermobility syndrome and identify factors that may be contributing to your pain. Examples of how a physiotherapist or osteopath may help include:

• Provide education about self-management strategies to protect hypermobile joints and avoid activities which put excessive stress on joints⁴;
• Suggest braces and other protective devices to protect joints that frequently sublux or dislocate⁴;
• Prescribing an individualised exercise program to increase strength and improve control of movement through hypermobile joints and pain management strategies²;
• Assist in improving regular physical activity levels for weight management as being overweight may increase symptoms in those who are hypermobile⁸; and
• Your clinician may also refer to other health professionals such as exercise physiologists, podiatrists, psychologists, GPs, dieticians, rheumatologists and others to optimise outcomes.

If you’d like more information or would like to book in for an appointment, please contact us on 9439 6776.

This blog is written by Narin Deniz, Physiotherapist at Back In Motion Eltham.

References:

1. Beighton, P. H., Solomon, L., & Soskolne, C. L. (1973). Articular mobility in an African population. Annals of the Rheumatic Diseases, 32(5), 413. doi 10.1136/ard.32.5.413
2. Castori, M., Morlino, S., Celletti, C., Celli, M., Morrone, A., Colombi, M., ... & Grammatico, P. (2012). Management of pain and fatigue in the joint hypermobility syndrome (aka Ehlers–Danlos syndrome, hypermobility type): principles and proposal for a multidisciplinary approach. American Journal of Medical Genetics Part A, 158(8), 2055-2070. doi 10.1002/ajmg.a.35483
3. Coles, W., Copeman, A., & Davies, K. (2018). Hypermobility in children. Paediatrics and Child Health, 28(2), 50-56. doi 10.1016/j.paed.2017.12.001
4. Keer, R., & Simmonds, J. (2011). Joint protection and physical rehabilitation of the adult with hypermobility syndrome. Current Opinion in Rheumatology, 23(2), 131-136. doi 10.1097/BOR.0b013e328342d3af
5. Kirk, J. A., Ansell, B. M., & Bywaters, E. G. (1967). The hypermobility syndrome. Musculoskeletal complaints associated with generalized joint hypermobility. Annals of the Rheumatic Diseases, 26(5), 419. doi 10.1136/ard.26.5.419
6. Russek, L. N., Stott, P., & Simmonds, J. (2019). Recognizing and effectively managing hypermobility-related conditions. Physical Therapy, 99(9), 1189-1200. doi 10.1093/ptj/pzz078
7. Simmonds, J. V. (2021). Masterclass: Hypermobility and hypermobility related disorders. Musculoskeletal Science and Practice, 102465. doi 10.1016/j.msksp.2021.102465
8. Tobias, J. H., Deere, K., Palmer, S., Clark, E. M., & Clinch, J. (2013). Joint hypermobility is a risk factor for musculoskeletal pain during adolescence: findings of a prospective cohort study. Arthritis & Rheumatism, 65(4), 1107-1115. doi 10.1002/art.37836
9. Tran, S. T., Jagpal, A., Koven, M. L., Turek, C. E., Golden, J. S., & Tinkle, B. T. (2020). Symptom complaints and impact on functioning in youth with hypermobile Ehlers–Danlos syndrome. Journal of Child Health Care, 24(3), 444-457. doi 10.1177/1367493519867174